Diabetic muscle infarction is a rare condition which may present to a rheum
atologist. It was first reported in 1965. Two illustrative cases are descri
bed here and the mechanisms of pathogenesis discussed. Analysis of the publ
ished data, results of the muscle biopsies, and a technetium-99m sestamibi
scan suggest that the condition, which occurs against a background of diabe
tic microangiopathy, can be triggered by an ischaemic event and causes exte
nsive muscle necrosis through hypoxia-reperfusion injury and compartment sy
ndrome.